Identifying and understanding the health and social care needs of older adults with multiple chronic conditions and their caregivers: a scoping review

doi:10.1186/s12877-018-0925-x

. 2018 Oct 1;18(1):231.

doi: 10.1186/s12877-018-0925-x.

Identifying and understanding the health and social care needs of older adults with multiple chronic conditions and their caregivers: a scoping review

Katherine S McGilton^{1

2}, Shirin Vellani³, Lily Yeung³, Jawad Chishtie^{4

5}, Elana Commisso⁶, Jenny Ploeg⁷, Melissa K Andrew⁸, Ana Patricia Ayala⁹, Mikaela Gray⁹, Debra Morgan¹⁰, Amanda Froehlich Chow¹⁰, Edna Parrott¹¹, Doug Stephens¹¹, Lori Hale¹¹, Margaret Keatings¹¹, Jennifer Walker¹², Walter P Wodchis^{6

13}, Veronique Dubé¹⁴, Janet McElhaney¹⁵, Martine Puts³

Affiliations

¹ Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada. kathy.mcgilton@uhn.ca.
² Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, ON, M6K 2R7 416 597 3422 (2500), Canada. kathy.mcgilton@uhn.ca.
³ Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.
⁴ Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, ON, M6K 2R7 416 597 3422 (2500), Canada.
⁵ Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.
⁶ Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
⁷ School of Nursing, McMaster University, Hamilton, ON, Canada.
⁸ Division of Geriatric Medicine, Dalhousie University, Halifax, NS, Canada.
⁹ Gerstein Information Science Centre, University of Toronto, Toronto, ON, Canada.
¹⁰ Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada.
¹¹ The Change Foundation, Toronto, ON, Canada.
¹² Laurentian University, Sudbury, ON, Canada.
¹³ Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada.
¹⁴ Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada.
¹⁵ Health Sciences North Research Institute and Northern Ontario School of Medicine, Sudbury, ON, Canada.

PMID: 30285641
PMCID: PMC6167839
DOI: 10.1186/s12877-018-0925-x

Identifying and understanding the health and social care needs of older adults with multiple chronic conditions and their caregivers: a scoping review

Katherine S McGilton et al. BMC Geriatr. 2018.

. 2018 Oct 1;18(1):231.

doi: 10.1186/s12877-018-0925-x.

Authors

Affiliations

¹ Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada. kathy.mcgilton@uhn.ca.
² Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, ON, M6K 2R7 416 597 3422 (2500), Canada. kathy.mcgilton@uhn.ca.
³ Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.
⁴ Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, ON, M6K 2R7 416 597 3422 (2500), Canada.
⁵ Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.
⁶ Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
⁷ School of Nursing, McMaster University, Hamilton, ON, Canada.
⁸ Division of Geriatric Medicine, Dalhousie University, Halifax, NS, Canada.
⁹ Gerstein Information Science Centre, University of Toronto, Toronto, ON, Canada.
¹⁰ Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada.
¹¹ The Change Foundation, Toronto, ON, Canada.
¹² Laurentian University, Sudbury, ON, Canada.
¹³ Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada.
¹⁴ Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada.
¹⁵ Health Sciences North Research Institute and Northern Ontario School of Medicine, Sudbury, ON, Canada.

PMID: 30285641
PMCID: PMC6167839
DOI: 10.1186/s12877-018-0925-x

Abstract

Background: As the population is aging, the number of persons living with multiple chronic conditions (MCC) is expected to increase. This review seeks to answer two research questions from the perspectives of older adults with MCC, their caregivers and their health care providers (HCPs): 1) What are the health and social care needs of community-dwelling older adults with MCC and their caregivers? and 2) How do social and structural determinants of health impact these health and social care needs?

Methods: We conducted a scoping review guided by a refinement of the Arksey & O'Malley framework. Articles were included if participants were 55 years or older and have at least two chronic conditions. We searched 7 electronic databases. The data were summarized using thematic analysis.

Results: Thirty-six studies were included in this review: 28 studies included participants with MCC; 12 studies included HCPs; 5 studies included caregivers. The quality of the studies ranged from moderate to good. Five main areas of needs were identified: need for information; coordination of services and supports; preventive, maintenance and restorative strategies; training for older adults, caregivers and HCPs to help manage the older adults' complex conditions; and the need for person-centred approaches. Structural and social determinants of health such as socioeconomic status, education and access influenced the needs of older adults with MCC.

Conclusion: The review highlights that most of the needs of older adults with MCC focus on lack of access to information and coordination of care. The main structural and social determinants that influenced older adults' needs were their level of education/health literacy and their socioeconomic status.

Keywords: Caregivers; Health care providers; Multimorbidity; Needs; Older adults; Scoping review.

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N/A

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Competing interests

The authors declare that they have no competing interests.

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References

1. Marengoni A, Rizzuto D, Wang HX, Winblad B, Fratiglioni L. Patterns of chronic multimorbidity in the elderly population. J Am Geriatr Soc. 2009;57(2):225–230. doi: 10.1111/j.1532-5415.2008.02109.x. - DOI - PubMed
1. Pefoyo AJ, Bronskill SE, Gruneir A, Calzavara A, Thavorn K, Petrosyan Y, Maxwell CJ, Bai Y, Wodchis WP. The increasing burden and complexity of multimorbidity. BMC Public Health. 2015;15:415. doi: 10.1186/s12889-015-1733-2. - DOI - PMC - PubMed
1. Wallace E., Salisbury C., Guthrie B., Lewis C., Fahey T., Smith S. M. Managing patients with multimorbidity in primary care. BMJ. 2015;350(jan20 2):h176–h176. doi: 10.1136/bmj.h176. - DOI - PubMed
1. Fortin M, Mercer SW, Salisbury C: Introducing multimorbidity. In: ABC of Multimorbidity. Edited by Mercer SW, Salisbury C, Fortin M, First edition edn. West Sussex: UK John Wiley & Sons, Ltd. ; 2014: 1–25.
1. Ploeg J, Matthew-Maich N, Fraser K, Dufour S, McAiney C, Kaasalainen S, Markle-Reid M, Upshur R, Cleghorn L, Emili A. Managing multiple chronic conditions in the community: a Canadian qualitative study of the experiences of older adults, family caregivers and healthcare providers. BMC Geriatr. 2017;17(1):40. doi: 10.1186/s12877-017-0431-6. - DOI - PMC - PubMed

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[1] Marengoni A, Rizzuto D, Wang HX, Winblad B, Fratiglioni L. Patterns of chronic multimorbidity in the elderly population. J Am Geriatr Soc. 2009;57(2):225–230. doi: 10.1111/j.1532-5415.2008.02109.x. - DOI - PubMed

[2] Marengoni A, Rizzuto D, Wang HX, Winblad B, Fratiglioni L. Patterns of chronic multimorbidity in the elderly population. J Am Geriatr Soc. 2009;57(2):225–230. doi: 10.1111/j.1532-5415.2008.02109.x. - DOI - PubMed

[3] Pefoyo AJ, Bronskill SE, Gruneir A, Calzavara A, Thavorn K, Petrosyan Y, Maxwell CJ, Bai Y, Wodchis WP. The increasing burden and complexity of multimorbidity. BMC Public Health. 2015;15:415. doi: 10.1186/s12889-015-1733-2. - DOI - PMC - PubMed

[4] Pefoyo AJ, Bronskill SE, Gruneir A, Calzavara A, Thavorn K, Petrosyan Y, Maxwell CJ, Bai Y, Wodchis WP. The increasing burden and complexity of multimorbidity. BMC Public Health. 2015;15:415. doi: 10.1186/s12889-015-1733-2. - DOI - PMC - PubMed

[5] Wallace E., Salisbury C., Guthrie B., Lewis C., Fahey T., Smith S. M. Managing patients with multimorbidity in primary care. BMJ. 2015;350(jan20 2):h176–h176. doi: 10.1136/bmj.h176. - DOI - PubMed

[6] Wallace E., Salisbury C., Guthrie B., Lewis C., Fahey T., Smith S. M. Managing patients with multimorbidity in primary care. BMJ. 2015;350(jan20 2):h176–h176. doi: 10.1136/bmj.h176. - DOI - PubMed

[7] Fortin M, Mercer SW, Salisbury C: Introducing multimorbidity. In: ABC of Multimorbidity. Edited by Mercer SW, Salisbury C, Fortin M, First edition edn. West Sussex: UK John Wiley & Sons, Ltd. ; 2014: 1–25.

[8] Fortin M, Mercer SW, Salisbury C: Introducing multimorbidity. In: ABC of Multimorbidity. Edited by Mercer SW, Salisbury C, Fortin M, First edition edn. West Sussex: UK John Wiley & Sons, Ltd. ; 2014: 1–25.

[9] Ploeg J, Matthew-Maich N, Fraser K, Dufour S, McAiney C, Kaasalainen S, Markle-Reid M, Upshur R, Cleghorn L, Emili A. Managing multiple chronic conditions in the community: a Canadian qualitative study of the experiences of older adults, family caregivers and healthcare providers. BMC Geriatr. 2017;17(1):40. doi: 10.1186/s12877-017-0431-6. - DOI - PMC - PubMed

[10] Ploeg J, Matthew-Maich N, Fraser K, Dufour S, McAiney C, Kaasalainen S, Markle-Reid M, Upshur R, Cleghorn L, Emili A. Managing multiple chronic conditions in the community: a Canadian qualitative study of the experiences of older adults, family caregivers and healthcare providers. BMC Geriatr. 2017;17(1):40. doi: 10.1186/s12877-017-0431-6. - DOI - PMC - PubMed

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Identifying and understanding the health and social care needs of older adults with multiple chronic conditions and their caregivers: a scoping review

Affiliations

Identifying and understanding the health and social care needs of older adults with multiple chronic conditions and their caregivers: a scoping review

Authors

Affiliations

Abstract

Conflict of interest statement

Ethics approval and consent to participate

Consent for publication

Competing interests

Publisher’s Note

Figures

Similar articles

Cited by

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

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Molecular Biology Databases

Research Materials

Abstract

Conflict of interest statement

Ethics approval and consent to participate

Consent for publication

Competing interests

Publisher’s Note

Figures

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Cited by

References

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Related information

Grants and funding

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Medical

Molecular Biology Databases

Research Materials